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Background: Gonorrhea is the second most commonly reported notifiable disease in the United States. Epidemiologic and biologic studies provide strong evidence that gonococcal infections facilitate the transmission of HIV infection. For over a decade, Mississippi reported among the highest rate of gonorrhea. The purpose of this study is to describe the epidemiology of gonorrhea infections and identify risk factors associated with multiple infections.
Methods: Demographic data was reviewed from gonorrhea cases reported to the Mississippi State Department of Health’s STD Management Information System from January 1, 2005, through December 31, 2012. Characteristics of individuals with one chlamydia infection were compared to individuals with repeat infections. Further analyses were performed to assess risk factors associated with recent repeat gonorrhea infections (more than one infection between 1 and 6 months).
Results: During 2005-2012, Mississippi reported 56,463 gonorrhea episodes (40,108 single cases and 6,990 repeat infections). Among repeat infections, 2,471 (35.4%) were recent repeat infections. The mean age of individuals with chlamydia was 24 ± 7.8 years, with 68% of cases among individuals under 25 years. The number of repeat infections reported ranged from 2-10 per individual (mean = 2.3 + 0.8 cases). The mean time between first and second repeat infection was 18 months ± 18 months. In the multivariate analysis, factors associated with recent repeat infections included younger age, African American race, and urban residence.
Conclusions: In Mississippi recent cases reported with repeat gonococcal infections are more likely to be younger, be African American, and reside in urban areas. STD control programs may use this information to educate and re-enforce compliance with existing re-screening guidelines for patients treated with a gonococcal infection to health providers taking care of populations most at risk residing in urban areas.